As it enters its eighth decade, the NHS is struggling to cope with increasing demand and a limited budget.

No health system has all the answers, and there are certainly lessons the NHS can impart. But if the NHS is to thrive it needs to draw on the knowledge and experiences of other countries.

Here we look at five ideas from around the world that have the potential to transform the health service.

New Zealand: integrated health and social care

In the early 2000s, the health system in Canterbury on New Zealand’s South Island was under pressure as a result of increasing demand, leading to questions about its sustainability. But since it introduced an integrated health and social care system in 2007, Canterbury has turned around its fortunes.

Chris Ham, the chief executive of the King’s Fund thinktank, says the model in Canterbury is one that England should learn from as hospitals struggle to cope with record demand from an ageing population. In Canterbury, teams offer community-based rehab to older people to avoid admissions or get them home more quickly.

Community-based rehab is offered to older people to avoid hospital admissions. Photograph: Alamy

“The essence is, over the 10-year period, they’ve been able to build up their services out of hospitals, GPs and other community services and been able to reduce big increases in demand for hospital care they were experiencing when they started,” Ham says. “They’ve got GPs taking on more responsibility, [and] improved communications, making it far easier for GPs to talk to hospital specialists.”

Integrated care has long been talked about in England. The Department of Health was renamed the Department of Health and Social Care this year and 14 areas are currently participating in NHS England’s “integrated care development programme”, with positive initial results. But the health and social care systems remain separate entities with separate budgets.

Ham says the key is changing to a more collaborative approach after 25 years of the internal market and competition. In Canterbury, this has been achieved partly by training staff in quality improvement methods, with some visiting other organisations that already deploy them.

Sweden: paediatricians on the frontline

When it comes to the increasing pressures on the NHS, the spotlight often falls on Britain’s ageing population. But demand for services is also increasing among other age groups.

Prof Ingrid Wolfe, director of the Children and Young People’s Health Partnership (CYPHP) in south London, says there has been a 40% increase in emergency department attendances by children over the last five years, which means the number of young children going to A&E is exceeding the number of older people – “but that doesn’t hit the headlines”.

Infant mortality rates have recently begun rising in England and Wales after decades of improvement and the country lags behind Europe on many key indicators of children’s health. An unhealthy child will not only require more medical care in infancy but is also more likely to do so in adulthood.

Against this backdrop, CYPHP is an attempt to test a new model of everyday healthcare for children, drawing on proven ideas from abroad, in particular Sweden, where death rates from meningococcal disease, pneumonia and asthma among children are lower than in the UK.

A nurse speaks to a mother and child in the emergency unit of Astrid Lindgren Children’s hospital in Stockholm. Photograph: Bloomberg via Getty Images

In the UK the first port of call for parents is usually the GP, who will often have limited training in paediatrics. By contrast, in Sweden GPs and paediatricians are co-located in health centres where there is parental support, health education and promotions, all important for preventing ill health.

Building on the Swedish model, the CYPHP has teams including GPs, paediatricians, and children’s nurses offering a one-stop service for physical and mental health. But Wolfe says Sweden also places importance on addressing inequalities, which impact hugely on child health.

“We need to be looking at other countries, not just at the health system but the society around it,” she says. “In Sweden the social policy and economic policies protect children and families and in particular vulnerable children and families more than they do here.”

Israel: single patient record

Data sharing has become something of a dirty term in England after a series of security breaches. Care.data, the government’s scheme to store patients’ medical information in a single database, was scrapped amid concerns about confidentiality, including about data potentially being sold to insurance and pharmaceutical companies.

But Nigel Edwards, the chief executive of the Nuffield Trust, says other countries have reaped dividends from adopting a single record for each patient. He cites Israel, where health maintenance organisations (HMOs) oversee care, as an example of what can be achieved.

“If you’re using the health system in the HMO your health practitioner knows exactly what is happening to you, what your needs are,” says Edwards. “They’ll get reminders it’s time for you to have various preventative care, they have alerts about drugs which might interact negatively with each other.”

Israel has had success with a single database of patient records. Photograph: Getty Images

Primary data sharing is designed to ensure that the practitioner has all the details of the patient in front of them. Secondary data sharing has wider benefits, collating information about the efficacy of treatments and health professionals on a massive scale, facilitating research. If results were combined with data from other countries with registers, the system could be even more powerful.

Edwards says applying sophisticated regression models to a database to identify who is at risk from different conditions has the potential to make healthcare “more anticipatory, before something has gone wrong”.

By improving efficiencies, a single patient record can also free up the time of clinical staff, who, in the NHS, are working increasingly harder just to stand still.

Edwards admits the challenge is bigger for England, where the population is far higher than Israel, but says: “With the restrictions we place on data sharing, there’s a big risk we are going to miss out on the benefits. If we use data and information in better ways than we have done historically it would massively improve the efficiency of hospitals.”

Canada: innovation procurement

The NHS is the world’s single biggest buyer of healthcare products and its spending has long been under scrutiny. It has been claimed that it could save billions by making procurement more efficient. In Canada, which like the UK has a publicly funded health system, the province of Ontario is exploring the benefits of what it calls “innovation procurement”.

Dr Anne Snowdon, academic chair of the World Health Innovation Network at the University of Windsor, Ontario, describes it in simple terms as buying solutions rather than “stuff”.

Referencing a study that found three-quarters of people did not benefit from the 10 highest-grossing drugs in the US, she says: “Many health systems are spending a lot of money procuring products that they may not need or might not work or might even cause people harm. Isn’t it better to say this is the outcome we want to get to and if you don’t hit these targets then the industry has to pay the money back?”

Providers in Ontario are inviting companies to come up with solutions. Photograph: Thomas Northcut/Getty Images

Instead of just buying a drug or piece of equipment, health providers in Ontario are inviting companies to take part in design competitions and come up with solutions, focusing on measurable outcomes such as improving care by a certain amount or cutting costs by a specified sum.

Examples have included surgeons wanting to improve their accuracy by gaining greater visibility of the surgical field during operations, and an attempt to get care services to the community as quickly as possible, a challenge in Canada where the population is spread over a large area.

Snowdon says she has found little evidence of the innovation procurement model being used elsewhere, in health or otherwise – except by the Swedish railway – but says early results look extremely good.

“It’s no longer we just buy what’s on the market,” she says. “We work with industry who have the expertise but they also have to share in the outcomes and risk if it doesn’t work. Right now, health systems have 100% of the risk – that’s the fundamental difference.”

Denmark: one-stop cancer screening

The UK has long had cancer survival rates that lag behind countries with similar health systems and expenditure. One of the reasons for this is that cancer tends to be diagnosed later than in other countries. The later it is diagnosed the less the chance of surviving it – and the greater the cost of treating it.

Sara Hiom, the director of early diagnosis at Cancer Research UK, says the NHS can learn from from Denmark how to address the problem it has dealing with people with non-specific but concerning symptoms.

A woman having a breast exam. Photograph: Picture Partners/Getty Images

“If you are a GP and a patient presents with a breast or testicular lump, you are clear what pathway to put them on,” she says. “If you are presented with a patient who has vague symptoms such as losing weight or tiredness you have no specific pathway. You have one set of tests and, if those come back negative, a second set of tests so the patient ends up ping-ponging between primary and secondary care. All this time the tumour is potentially growing and may even be moving from stage one to stage two.”

In Denmark, a one-stop service is offered to people presenting possible cancer symptoms through multi-disciplinary diagnostic centres (MDCs). Instead of the NHS approach, which involves different tests carried out consecutively, in Denmark all the tests are done at once enabling them to come to a decision as to whether the patient has any form of cancer.

Hiom says MDCs in Denmark have increased detection of cancer at an earlier stage, while reducing anxiety and uncertainty for patients. A similar system is being trialled at 10 sites in England.

“We need to make it easier once they [patients] are in the health system for them to get the right diagnosis and have the results reported quickly,” she says, but adds that MDCs can only work in conjunction with adequate staffing.

“Whether it’s people doing endoscopies or radiologists, we don’t have enough of these type of people in the health service,” she says. “We need to have enough people to not only do the tests but report on the tests.”